Mind and Body

Vaccinations Help Improve Health throughout Life Span

Immunizations used to be the realm of the young. Babies would go through series after series of vaccinations. And toddlers would take their shots before entering preschool.

And they still do. But vaccines are now expanding to include all age ranges, in an attempt to ward off disease from the cradle to the grave.

What is more, immunization rates continue to gradually improve in the US, although not as quickly as public health officials would like.

About 77 percent of children 19 months to 35 months had received all their recommended vaccinations in 2007, according to the Centers for Disease Control and Prevention (CDC).

It falls short of the federal goal of 80 percent but is a small improvement over the 76 percent rate found in 2005.

"We may have a little way to go, but that's not bad," says Dr. Thomas Weida, at Penn State's Hershey Medical Center. The government's next goal is 90 percent of children in that age range immunized by 2010.

Teenage Years Important for Protection

Public health officials see these regular vaccinations as a wall holding back terrible diseases that have plagued mankind for centuries: measles, whooping cough, rubella, diphtheria, tetanus, and mumps, among others.

"Vaccines are probably one of the top two or three public health interventions of all time," says Dr. Doug Campos-Outcalt, at the University of Arizona College of Medicine. "They now have been so successful they suffer from their success, because people don't see the diseases and the horrors associated with them."

The immunization goals are part of an effort to ensure that even those who do not receive vaccinations will be protected from disease by those who do, says Dr. Weida.

"You get something called herd immunity, although I wish there were a better name for it," he notes. "If you get enough people vaccinated, even people who aren't vaccinated are protected, because the disease can't transmit. The virus can't get past the wall of vaccinated people we've created."

Most of the biggest changes in the immunization schedule have targeted preteens ages 11 to 12, says Dr. Campos-Outcalt.

There are new immunizations available for meningitis, human papillomavirus (HPV), and tetanus/diphtheria/pertussis in that age range.

"It's kind of a coincidence," says Dr. Campos-Outcalt. "Several vaccines for that age group just kind of came up."

The HPV immunization is unique in that it is the first vaccine that can prevent a form of cancer. Girls are provided the vaccine to prevent the spread of HPV, a sexually transmitted disease that can result in cervical cancer.

"The issue is explaining the vaccine at a time when neither the child nor the parent want to think about this, when the girl is still preteen," says Dr. Weida. "I say, 'This is to prevent cervical cancer, and you have to receive it before you're infected.' "

Unfortunately, some vaccinations have been lagging in teenagers. Researchers have found that immunization goals for children 13 to 17 have fallen short in all the recommended vaccines.

The problem is that most children enter public elementary schools, where there are strict immunization requirements, says Dr. Weida. Not as many go on to college, however, where they would face the same requirements.

"There's not the same push if you're not going to college, so they don't think about it," he says.

Flu, Plus Pneumonia and Shingles Now

Influenza is another disease receiving a huge immunization push from public health officials. The flu vaccine soon will be recommended for children through age 18, says Dr. Campos-Outcalt.

"I think eventually it will be universally recommended for everyone, every year," he says. "This is just an incremental step in that direction."

Dr. Weida agrees. "We need to do a better job at immunizing people against flu," he says. "Everyone over 50 should get one, and so should kids, because we're discovering they're the reservoir for flu. They're in a closed container called school, so they transmit it easily between themselves, and then they bring that little present home."

New vaccines also have been springing up for the elderly, specifically immunization that provides protection against pneumonia and shingles.

To keep track of all these changes, Dr. Weida recommends that families choose a physician and stick with him or her.

"If my patients come in for a routine visit or a sick visit, I'll look at their immunization record," he says. "You're not going to get that so much if you're bouncing around from provider to provider, because they're not going to have the record."

A more promising means of making vaccination easier is the movement toward creating nasal or oral vaccines, notes Dr. Campos-Outcalt. A nasal flu vaccine already has been produced, and others are on the way.